DOI: http://dx.doi.org/10.18203/2349-3933.ijam20170521

An unusual case of pericardial tamponade in primary hypothyroidism

Pavankumar Pyarsabadi, Manoj Saluja, Saurabh Chittora, Yogesh Swami, Hemanth Richariya, Kapil Jaiswal, Sudeep Javedar

Abstract


Pericardial effusion is not so uncommon in hypothyroidism, but pericardial tamponade is very rare entity. Hypothyroidism complicated by pericardial tamponade is very rarely referenced in the medical literature. Here we report a rare case of a 70 year old female, who presented with breathlessness and was found to have hypothyroidism with large pericardial effusion complicating into pericardial tamponade. Management included urgent pericardiocentesis followed by l-thyroxine supplementation.


Keywords


Hypothyroidism, L-thyroxine, Pericardial tamponade, Pericardial effusion, Pericardiocentesis

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References


Rernam VJ, Chichgar JA, Patkar LA. Myxedema and pericardial effusion with cardiac tam-ponade a case report. Journal Postgraduate Med. 1983;29:188-90.

Arthur S, Panray PG, Fitzgerald J. Hypothyroidism presenting with recurrent pericardial tam- ponade. BMJ Case Reports. 2009;1674.

Handler J. Hypertensive emergency with cardiac tamponade associated with hypothyroidism. Journal Clinical Hypertension. 2007;9:67-72.

Nacher JJ, Alonso N, Vega B. Cardiac tamponade as a presentation of primary hypothyroidism in a young woman. Revista Clínica Española. 1993;193:290-2.

Wang JL, Hsieh MJ, Lee CH. Hypothyroid cardiac tamponade: Clinical features, electrocardiography, pericardial fluid and management. Am J Med Sci. 2010;340:276-81.

Roy CL, Minor MA, Brookhart MA. Does this patient with a pericardial effusion have a car- diac tamponade? JAMA. 2007;297:1810-8.

Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113:1622-32.

Goswami R, Tandon N, Singh B. Circulatory collapse in a 30-year-old amenorrheic woman. Post- Graduate Med J. 1997;72:501-9.

Parving A, Ostri B, Bretlau P. Mechanisms of edema formation in myxedema increased protein extravasation and relatively slow lymphatic drainage. New England J Med. 1979;301:460-5.

Spodick DH. Acute cardiac tamponade. New England J Med. 2003;349:684-90.

Fazio S, Palmieri EA, Lombardi G. Effects of thyroid hormone on cardiovascular system. Recent Progress Hormone Research. 2004;59:31-50.

Foley CM, Mcallister RM, Hasser EM. Thyroid status influences baroreflex function and auto- nomic contributions to arterial pressure and heart rate. Am J Physiol Heart Circulatory Physiol. 2001;280:2061-8.

Alsever RN, Stjernholm. Cardiac tampo-nade in myxedema. The American Journal of the Medical Sciences. 1975;269:117-21.

Gumrukcuoglu HA, Odabasi D, Akdag S. Management of cardiac tamponade: A comparative study between echo-guided pericardiocentesis and surgery a report of 100 patients. Cardiology Reasearch and Practice. 2011;38:7.